Active NPI
Modesta Gaerlan-Tokunaga, DDS
- General Practice Dentistry
- Waipahu, HI
National Provider Identifier
1457430985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DT 1529
- Practice address
- 94-307 Farrington Hwy Ste A10
Waipahu, HI 96797-2500 - Phone
- (808) 671-9166
- Fax
- (808) 671-6236
- NPI assigned
- Nov 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DT 1529 | HI | Primary |
Addresses
Primary practice location
94-307 Farrington Hwy Ste A10
Waipahu, HI 96797-2500
Mailing address
94-307 Farrington Hwy Ste A10
Waipahu, HI 96797-2500
Phone (808) 671-9166
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041315 | Medicaid | HI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT 1529 | HI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457430985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94-307 FARRINGTON HWY STE A10",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967972500",
"telephone_number": "808-671-9166",
"fax_number": "808-671-6236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94-307 FARRINGTON HWY STE A10",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967972500",
"telephone_number": "808-671-9166",
"fax_number": "808-671-6236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAERLAN-TOKUNAGA",
"first_name": "MODESTA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "HI",
"license": "DT 1529",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "041315",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waipahu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.